13 April 2007

Sorry for the prolonged radio silence. Real life gets in the way of blogging sometimes. As my hero, Monty Burns said: "Family, religion, friends.. these are the three demons you must slay if you wish to succeed..." Well, I'm back with an annoyed rant, yet again on the Joint Commission. Apparently they have recovered from the temporary bout of sanity which caused their earlier hesitation and reinstated this odious rule:

Joint Commission Reinstates First Dose Medication Review

Medications administered in an emergency department must once again be reviewed prospectively by a pharmacist, according to a notification sent to hospitals last week by the Joint Commission. But a conversation with the Joint Commission president indicates that the reversal may not be permanent.

ACEP President Brian Keaton, MD, spoke with Dennis O’Leary, MD, the Joint Commission president, on April 13. According to Marilyn Bromley, RN, Director of ACEP’s EM Practice Department, Dr. O’Leary indicated that he would convene an internal task force to revisit the many concerns presented to the Joint Commission.

You can read the proposed rule here. Once again, the bureaucratic mindset took control of the residual brainstems of the great thinkers at the Joint Commission, and heedless of the lack of qualified pharmacists to review the volume of orders for meds in the ER, mindless of the needless delays in dispensing critical medications, mindless of the obligate delays in care, increased length of stay, increased waiting times, impact on patient flow, etc, they reinstate a stupid rule which not only unnecessary but potentially detrimental to patient care.

You will note that ACEP is opposing this. Never say that your college doesn't do anything for you.

7 comments:

Just a thought - you might try checking in with the Institute for Healthcare Improvement website to see who else is having issues with this. That might be a good cyber town hall forum to mass support for pushing back JCAHO.

Yikes is all I can say. Where does JCAHO think all of the needed pharmacists are going to come from? What about critical access hospitals? What about rural/underserved hospitals? What about patient flow, that they are all hot to trot about?

You have my sympathy - let me know if I can be of help - used to be my old stomping ground.

ER Nurse in Cali here- love reading your blog. According to our charge nurses, we are working around this by the doctor writing STAT after every single med order. Seems stupid that we just have to keep coming up with random ways of getting around JCAHO. It would be a lovely dream if the people who instituted the rules actually had to work in various ares of pt care- at least a couple of times a month!

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

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